This episode offers an overview of medications for labor pain and childbirth – nitrous oxide, IV opioids, and epidural analgesia. For each it covers how it’s administered, the benefits – how it helps with labor pain, and the possible side effects. There is also a detailed discussion of labor support for a person using epidural analgesia.

Continuous labor support, which can be provided by a partner or spouse, other family or friends, a professional doula or by medical caregivers has been shown to reduce interventions, improve outcomes, and improve satisfaction with the birth. This episode is all about how to provide effective labor support: by learning about childbirth, learning about what best comforts the person you will support in labor, creating an environment where she is comfortable and feels able to do what she needs to do to cope without being judged, watching for Relaxation, Rhythm, and Ritual and reinforcing those, and – most importantly – helping her to feel safe, loved and protected. When someone feels safe, loved and protected, oxytocin and endorphins flow, and labor progresses faster and hurts less. [Transcript of episode.]

Learn comfort techniques and learn why they work. Cognitive strategies include education, visualization, affirmations, and choosing to view pain as a positive sign of labor progress. Gate Control techniques work by focusing your attention on something pleasant (like music, a beautiful view or aromatherapy) instead of focusing on the labor pain – this blocks pain signals from reaching the brain, so you’ll experience less pain. Counter-irritants include things like biting your lip – a pain you control – to help make the pain you can’t control feel more manageable. And body mechanics involves using position, movement and massage to encourage baby to move into the best position to help labor to progress and be less painful. Here’s a printable handout that summarizes comfort techniques for labor.

An overview of the stages of labor and comfort techniques for the first stage of labor: Early labor, as the cervix moves from 0 to 5 cm dilated is the longest phase of labor, but also the least intense. The focus is on Relaxation, so techniques like slow deep breathing visualization, massages and baths all help. In active labor as the cervix goes from 5 to 8 cm, contractions are longer, stronger, and closer together and take more work to cope with. The focus is on Rhythm, so rhythmic breathing helps, as does movement such as walking, slow dancing, or rocking on a birth ball or in a rocking chair. In transition, as the cervix dilates to 10 cm, contractions are coming hard and fast and it can be very overwhelming. So, the focus is Ritual – find something that works to reduce pain, and just keep doing it on every contraction to help feel like there’s some control over the process. [Transcript of podcast episode 3 at: https://transitiontoparenthood.wordpress.com/for-parents/labor-and-birth/]

I discuss the physiology of pain and ways that people who have been through birth describe how contractions feel. Given all of the physical changes and challenges of labor, it’s not surprising it is painful for many people. The acronym P.A.I.N. can remind us that labor pain is Purposeful, Anticipated, Intermittent, and Normal. However, understanding what factors make that pain worse than it has to be helps us learn how to reduce it. The Fear Tension Pain Triangle theory tells us that when we’re fearful, we tense up. As we tense, the pain increases, which frightens us more…. the fear increases, and so on. Instead, we want to explore ways to shift this to the Confidence Relaxation Comfort Triangle to make labor more manageable. [Transcript of podcast episode.]

Podcast Episode 1: The most common question from people preparing for labor is ‘how will we handle the pain’? This episode provides an overview of all the tools that we can stock in a Toolbox for Coping with Labor Pain. It introduces both non-drug comfort techniques and pain medications, explores how the choice of pain coping techniques influences the whole experience of labor, and discusses the Pain Medication Preference Scale, a helpful tool for clarifying and summarizing priorities related to pain medication. Knowing someone’s preference helps to guide the labor support team in how to support them through the challenges of labor. Learn about all these tools by listening to more episodes of this podcast, or by reading Pregnancy, Childbirth, and the Newborn.